Endogenous endophthalmitis associated with autoimmune hepatitis: case report
DOI: 10.32364/2311-7729-2023-23-3-9
D.F. Belov1, V.G. Korotkov1, P.A. Nikitin2, I.V. Terekhova1, Ya.S. Konenkova1
1City Multidisciplinary Hospital No. 2, St. Petersburg, Russian Federation
2Scientific and Clinical Center No. 2 of the Academician B.V. Petrovskiy Russian Scientific Center of Surgery, Moscow, Russian Federation
Endogenous endophthalmitis (EE) is a severe inflammatory disease resulting from hematogenous dissemination of pathogenic agents (bacteria, fungi) from the primary focus into the choroid due to impaired permeability of blood-ocular barrier. Retina, vitreous body, and anterior chamber are further involved. This paper describes a 61-year-old woman with EE associated with autoimmune hepatitis (AIH). Ocular inflammation was preceded by bacteremia. Clinical signs of EE included vitreitis, choroidal effusion, and exudative retinal detachment followed by amaurosis and phthisis bulbi. In 2008, the woman was diagnosed with AIH of unknown origin. Insulin-dependent diabetes developed secondary to treatment with prednisolone. After canceling steroids, AIH progressed to cirrhosis. Here, the development of EE was probably associated with secondary immunodeficiency in the setting of AIH. The timely diagnosis of EE is important for selecting an effective treatment strategy that involves intravitreal antibiotics and vitrectomy. Ophthalmologists should be aware of previous fever or flu-like disorder, severe ocular inflammation (hypopion, vitreitis, choroidal effusion, retinal detachment), no red reflex, and severe vision loss.
Keywords: endogenous endophthalmitis, autoimmune hepatitis, vitrectomy, intravitreal injections, and phthisis bulbi, hypopyon, choroid, bacteremia, cirrhosis, retinal detachment.
For citation: Belov D.F., Korotkov V.G., Nikitin P.A., Terekhova I.V., Konenkova Ya.S. Endogenous endophthalmitis associated with autoimmune hepatitis: case report. Russian Journal of Clinical Ophthalmology. 2023;23(3):164–169 (in Russ.). DOI: 10.32364/2311-7729-2023-23-3-9.
About the authors:
Dmitriy F. Belov — C. Sc. (Med.), ophthalmologist, City Multidisciplinary Hospital No. 2; 5, Uchebnyy lane, St. Petersburg, 194354, Russian Federation; ORCID iD 0000-0003-0776-4065.
Vasiliy G. Korotkov — therapist, City Multidisciplinary Hospital No. 2; 5, Uchebnyy lane, St. Petersburg, 194354, Russian Federation; ORCID iD 0000-0002-1797-5125.
Pavel A. Nikitin — C. Sc. (Med.), radiologist, Scientific and Clinical Center No. 2 of the Academician B.V. Petrovskiy Russian Scientific Center of Surgery; 1A, Litovskiy blvd., Moscow, 117593, Russian Federation; ORCID iD 0000-0003-1809-6330.
Irina V. Terekhova — ophthalmologist, Head of the Consultative Diagnostic Department of Ophthalmology, City Multidisciplinary Hospital No. 2; 5, Uchebnyy lane, St. Petersburg, 194354, Russian Federation; ORCID iD 0000-0002-8666-1541.
Yanina S. Konenkova — ophthalmologist, Head of the Microsurgical (Eye) Department No. 4, City Multidisciplinary Hospital No. 2; 5, Uchebnyy lane, St. Petersburg, 194354, Russian Federation; ORCID iD 0000-0002-1346-9022.
Contact information: Dmitriy F. Belov, e-mail: belovd1990@gmail.com.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 03.07.2022.
Revised 26.07.2022.
Accepted 18.08.2022.
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